NSG 5140 ADVANCED PATHOPHYSIOLOGY – MIDTERM EXAM |
QUESTIONS AND ANSWERS | VERIFIED ANSWERS WITH
RATIONALES | LATEST EXAM UPDATE
1. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excess hepatic glucose production
D. Impaired insulin receptor function
Answer: B. Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by autoimmune-mediated
destruction of pancreatic beta cells, leading to absolute insulin
deficiency.
2. Which electrolyte imbalance is most commonly associated with chronic
kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hyperkalemia
Rationale: CKD reduces potassium excretion, leading to hyperkalemia,
which can cause cardiac arrhythmias.
3. A patient presents with severe diarrhea. Which acid-base disturbance is
most likely?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: A. Metabolic acidosis
Rationale: Loss of bicarbonate in diarrhea leads to metabolic acidosis.
4. In heart failure, activation of the renin-angiotensin-aldosterone system
(RAAS) primarily causes:
A. Vasodilation and decreased blood pressure
B. Sodium and water retention
, C. Increased diuresis
D. Bradycardia
Answer: B. Sodium and water retention
Rationale: RAAS activation increases sodium and water reabsorption to
maintain perfusion, which can worsen fluid overload in heart failure.
5. Which of the following best describes the pathophysiology of multiple
sclerosis?
A. Autoimmune destruction of myelin in the CNS
B. Degeneration of peripheral nerves
C. Accumulation of amyloid plaques in the brain
D. Inflammation of the neuromuscular junction
Answer: A. Autoimmune destruction of myelin in the CNS
Rationale: MS is an autoimmune demyelinating disorder affecting the
central nervous system, leading to conduction deficits.
6. Which condition is characterized by excessive cortisol secretion?
A. Addison’s disease
B. Cushing’s syndrome
C. Hypothyroidism
D. Pheochromocytoma
Answer: B. Cushing’s syndrome
Rationale: Cushing’s syndrome results from chronic cortisol excess,
causing hyperglycemia, hypertension, and central obesity.
7. What is the primary mechanism of tissue injury in hypovolemic shock?
A. Direct cytotoxicity
B. Decreased tissue perfusion leading to hypoxia
C. Autoimmune attack on organs
D. Overactivation of coagulation cascade
Answer: B. Decreased tissue perfusion leading to hypoxia
Rationale: Hypovolemic shock reduces circulating blood volume,
decreasing tissue oxygen delivery and causing cellular injury.
8. Which lab finding is consistent with iron-deficiency anemia?
A. High MCV and low ferritin
B. Low MCV and low ferritin
C. Normal MCV and high ferritin
D. Low MCV and high ferritin
Answer: B. Low MCV and low ferritin
Rationale: Iron-deficiency anemia causes microcytic (low MCV),
hypochromic red cells with depleted iron stores (low ferritin).
, 9. Which pathogenetic mechanism underlies rheumatoid arthritis?
A. Autoimmune-mediated joint inflammation
B. Degeneration of articular cartilage due to wear and tear
C. Deposition of uric acid crystals
D. Infectious joint inflammation
Answer: A. Autoimmune-mediated joint inflammation
Rationale: RA involves autoimmune attack on synovial membranes,
leading to chronic joint inflammation and destruction.
10. A patient with COPD is most likely to have which blood gas
abnormality?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: C. Respiratory acidosis
Rationale: COPD leads to hypoventilation and CO2 retention, causing
chronic respiratory acidosis.
11. The primary pathophysiologic change in myocardial infarction is:
A. Reversible ischemia of myocardial cells
B. Necrosis due to prolonged ischemia
C. Infection of the myocardium
D. Fibrosis without cell death
Answer: B. Necrosis due to prolonged ischemia
Rationale: MI occurs when coronary blood flow is blocked, leading to
irreversible necrosis of myocardial tissue.
12. Which hormone imbalance is most responsible for hyperthyroidism?
A. Excess TSH
B. Excess T3/T4
C. Low TSH
D. Low cortisol
Answer: B. Excess T3/T4
Rationale: Hyperthyroidism is caused by elevated thyroid hormones (T3
and T4), which increase metabolic rate and sympathetic activity.
13. In cirrhosis, portal hypertension is primarily caused by:
A. Increased cardiac output
B. Fibrosis and vascular resistance in the liver
C. Dehydration
D. Autoimmune hepatitis
QUESTIONS AND ANSWERS | VERIFIED ANSWERS WITH
RATIONALES | LATEST EXAM UPDATE
1. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excess hepatic glucose production
D. Impaired insulin receptor function
Answer: B. Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by autoimmune-mediated
destruction of pancreatic beta cells, leading to absolute insulin
deficiency.
2. Which electrolyte imbalance is most commonly associated with chronic
kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hyperkalemia
Rationale: CKD reduces potassium excretion, leading to hyperkalemia,
which can cause cardiac arrhythmias.
3. A patient presents with severe diarrhea. Which acid-base disturbance is
most likely?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: A. Metabolic acidosis
Rationale: Loss of bicarbonate in diarrhea leads to metabolic acidosis.
4. In heart failure, activation of the renin-angiotensin-aldosterone system
(RAAS) primarily causes:
A. Vasodilation and decreased blood pressure
B. Sodium and water retention
, C. Increased diuresis
D. Bradycardia
Answer: B. Sodium and water retention
Rationale: RAAS activation increases sodium and water reabsorption to
maintain perfusion, which can worsen fluid overload in heart failure.
5. Which of the following best describes the pathophysiology of multiple
sclerosis?
A. Autoimmune destruction of myelin in the CNS
B. Degeneration of peripheral nerves
C. Accumulation of amyloid plaques in the brain
D. Inflammation of the neuromuscular junction
Answer: A. Autoimmune destruction of myelin in the CNS
Rationale: MS is an autoimmune demyelinating disorder affecting the
central nervous system, leading to conduction deficits.
6. Which condition is characterized by excessive cortisol secretion?
A. Addison’s disease
B. Cushing’s syndrome
C. Hypothyroidism
D. Pheochromocytoma
Answer: B. Cushing’s syndrome
Rationale: Cushing’s syndrome results from chronic cortisol excess,
causing hyperglycemia, hypertension, and central obesity.
7. What is the primary mechanism of tissue injury in hypovolemic shock?
A. Direct cytotoxicity
B. Decreased tissue perfusion leading to hypoxia
C. Autoimmune attack on organs
D. Overactivation of coagulation cascade
Answer: B. Decreased tissue perfusion leading to hypoxia
Rationale: Hypovolemic shock reduces circulating blood volume,
decreasing tissue oxygen delivery and causing cellular injury.
8. Which lab finding is consistent with iron-deficiency anemia?
A. High MCV and low ferritin
B. Low MCV and low ferritin
C. Normal MCV and high ferritin
D. Low MCV and high ferritin
Answer: B. Low MCV and low ferritin
Rationale: Iron-deficiency anemia causes microcytic (low MCV),
hypochromic red cells with depleted iron stores (low ferritin).
, 9. Which pathogenetic mechanism underlies rheumatoid arthritis?
A. Autoimmune-mediated joint inflammation
B. Degeneration of articular cartilage due to wear and tear
C. Deposition of uric acid crystals
D. Infectious joint inflammation
Answer: A. Autoimmune-mediated joint inflammation
Rationale: RA involves autoimmune attack on synovial membranes,
leading to chronic joint inflammation and destruction.
10. A patient with COPD is most likely to have which blood gas
abnormality?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: C. Respiratory acidosis
Rationale: COPD leads to hypoventilation and CO2 retention, causing
chronic respiratory acidosis.
11. The primary pathophysiologic change in myocardial infarction is:
A. Reversible ischemia of myocardial cells
B. Necrosis due to prolonged ischemia
C. Infection of the myocardium
D. Fibrosis without cell death
Answer: B. Necrosis due to prolonged ischemia
Rationale: MI occurs when coronary blood flow is blocked, leading to
irreversible necrosis of myocardial tissue.
12. Which hormone imbalance is most responsible for hyperthyroidism?
A. Excess TSH
B. Excess T3/T4
C. Low TSH
D. Low cortisol
Answer: B. Excess T3/T4
Rationale: Hyperthyroidism is caused by elevated thyroid hormones (T3
and T4), which increase metabolic rate and sympathetic activity.
13. In cirrhosis, portal hypertension is primarily caused by:
A. Increased cardiac output
B. Fibrosis and vascular resistance in the liver
C. Dehydration
D. Autoimmune hepatitis
